"I'm not here, this isn't happening": Interoception and its role in dissociation - A systematic review

Alterations in interoceptive integration and processing have recently been proposed as a potential underlying mechanism for the onset of dissociative pathology. To date, researchers have sought to assess these hypotheses by measuring baseline differences in interoception across relevant samples (e.g., individuals with dissociative symptoms vs. healthy controls) or comparing interoception before and after laboratory-based inductions of state dissociation. However, empirical findings across such studies have been equivocal, and there has yet to be a review that compiles their findings related to interoception and its dimensions (e.g., interoceptive accuracy, sensibility, awareness) and dissociative experiences. Thus, this review highlights studies that assess either baseline differences in interoception in case and controls or following laboratory-based inductions of state dissociation. Additionally, this review also included research looking at correlates of interoception and dissociation to explain this relation more fully. Utilizing a comprehensive search strategy, over 3000 articles were reviewed, with eight meeting criteria. Of the eligible studies, 87.50 % found at least one significant difference in interoception, and all studies met an average of 83.33 % of the total points from a quality and risk of bias assessment tool. In addition to providing descriptive information about each study, we highlight trends, heterogeneous findings, and methodological concerns. We conclude with recommendations for researchers moving forward, including improving measurement (e.g., utilizing multimodal assessments of interoception), accounting for confounding influences (e.g., metacognitive deficits), and elucidating the directionality of the relation between interoception and dissociation.